Ostomy Reordering

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Protect Your Health

Routine replacement of your ostomy supplies is important. Ensure you are receiving the greatest benefit from your therapy, and protect your health by filling out the order form below.

Health Essentials will ship ostomy supplies directly to your home.

Ostomy Supply Order Form

Your insurance provider may reimburse you for the cost of these items:*

Contact Info

If applicable, please provide the city and state of the Health Essentials location currently serving you.

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Enter the text into the box below:
Recommended Replacement Schedule
Wafer Brand Ref#
Pouch Brand Ref#
One Piece System Brand Ref#
Paste Brand Ref#
Barrier Wipes Brand Ref#
Remover Wipes Brand Ref#
Powder Brand Ref#
Odor Eliminator Drop Brand Ref#
Belt Brand Ref#
Other Brand Ref#
Other Brand Ref#
Other Brand Ref#

Completing this form does not constitute an order.

A Health Essentials Representative will contact you within 2 business days regarding your comment.

Thank you! As an alternative to submitting an electronic message, you may contact us by phone—toll-free—by calling (417) 347-7400.

*Health Essentials must verify coverage of any item(s) ordered before shipping to patients.

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We are accredited by HQAA.
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